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New Missouri Law Aims To Protect Consumers


A new Missouri law aims to protect consumers from Anthem’s emergency room policy, News-Leader reports. The controversial policy, which CQC has previously reported on, states that consumers’ claims for emergency room visits can be retroactively denied if Anthem does not consider the visit an emergency.

Since implementing the policy in six states, Anthem has denied claims that have left patients responsible for thousands of dollars in medical bills.

The bill, introduced by State Sen. Paul Wieland, was signed on June 1st and will become law on August 28th.

"This bill has always been about consumer protection and ensuring patients get the proper coverage they are paying for," Wieland said in a statement.

The bill does so by reinforcing consumer protections.

The soon-to-be law reinforces the "prudent layperson" standard, which is a legal protection for people with an average knowledge of health and medicine. The bill is intended to protect people who believe they have an emergency medical condition and go to the emergency room to seek treatment, even if the final diagnosis is not considered an emergency.

Evan Schwarz, president of the Missouri College of Emergency Physicians, hopes the bill will help consumers:

"There may still be some ways for Anthem to get around this," he said. "The other major concern that we have is that message is already out there that your care may be denied, and we're afraid that if people have that message already that they may not seek help. We feel that if patients think they're having an emergency that they should be able to go to an emergency department and that if they have insurance that that insurance will cover that."


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